secretory disease

Question 1

pathophysiology of peptic ulcers

Answer 1

peptic ulcers are open sores that are developed in the inner lining of the stomach, upper intestine or the oesophagus ( upper gi disorder, the erosion of the mucosal layer).

1, H. PYLORI - this si the bacterium that co,lionises rage to ach lining and weakens the protective mucous layer , allowing acid to penetrate and damage the underlying tissues , this then produces enzymes and toxins that disrupt the gastric mucosal barrier and induces inflammation which then leads to and ulcer forming

2. NSAIDs thses will irritate the lining of the stomach and inhibit the production of prostaglandins=, which help maintain the mucosal barrier. prolonged use f nsaid or using in high doses increase the risk of a peptic ulcer by compromising the defence mechanism and promoting mucosal injury
3. excess gastric production- due to increased stimulation of gastrin or impaired regulation by proton pump inhibition (PPIs) can lead to erosion of the gastric mucosa and ulcer formation.
4. impaired mucosal defense mechanisms - the gastric mucosa is normally protected by layers of mucus. bicarbonate secretion and prostaglandins that neutralise acid and promote mucosal healing. disruption of these defences either by the H. pylori infection, nsaids or other factors can render the mucosa more suceptible to injury and ulcer formation

Question 2

pharmacology - ppis

Answer 2

proton pump inhibitors - ppis
moa - block the proton pump in the gastric parietal cells thereby reducing the secretion of gastric acid in the stomach and lumen. most commonly used to treat peptic ulcers, GERD and preventing nsaid induced ulcers

examples

omePRAZOLE, lansoPRAZOLE, esomePRAZOLE, panloPRAZOLE
adverse reaction - long term use can increase risk of infection, bone fraction and vitamin b12 deficiency

Question 3

pharmacology - histamine -2- receptor anatagonists (H2RAs)

Answer 3

moa - they. block the histamine on the h2 receptors on gastric parietal cells, leading to decreased secretion of gastric acid.

example

ranTIDINE, famoTIDINE , cimeTIDINE

adverse reaction - constipation, diarrhoea, electrolyte imbalance, retoma hyperactivity with prolonged use of

Question 4

mucosal protective agents

Answer 4

moa - enhance mucosal defense mechanisms, promote ulcer healing and protect the gastric mucosa from injury
these are used as adjunctive therapy for treatment of peptic ulcers

examples - sucrafate, bismuth, subsalicylate

adverse reaction - constipation

Question 5

antibiotics

Answer 5

• these are used to eradicate H. Pylori infection and they are used in combination with acid suppressing medications for one eradication of the infection

examples , amoxicillin, metronidazole, levofloxacin, clarithromycin

adverse reaction - antibiotic resistance, allergic reaction